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Attention Deficit Disorder (ADD/ADHD) is not a "Disease."


NOT a disease?

Clearly, people with ADD/ADHD have problems and personal issues, regardless of their age, but they do not feel "sick," and most do not think that their difficulties in life exist because they have a "disease."

What do they have if they do not have a disease? To start with, individuals with a history of hyperactivity, impulsivity and inattention "without cause" very likely have ADD/ADHD brain chemistry.

Now, for the terminological twist. Those in distress because of ADD/ADHD behavioral characteristics have a significantly increased risk of suffering death, pain, disability and/or an important loss of freedom. They are medically defined as having the "Mental Disorder" called ADD/ADHD. These individuals should seek help from a health professional to confirm that ADD/ADHD characteristics are in deed present and document that an important degree of distress and/or disability is due to these behavioral characteristic.

For physicians, it is critical to establish the presence of distress and/or ADD/ADHD disability according to the criteria described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to justify treatment and the prescribing of ADD/ADHD medication.

On the other hand, many people with hyperactivity, impulsivity and inattention do have ADD/ADHD brain chemistry but not significant distress or disability. According to the DSM-IV, their ADD/ADHD behaviors should be considered within the boundaries of "normal." Also, from a practical standpoint, in the absence of distress or disability it is difficult to evaluate the efficacy of ADD/ADHD medication if it were to be prescribed.

In summary, the diagnosis of ADD/ADHD, the Mental Disorder, depends on a detailed assessment of brain function and the clinical judgment of a professional that there is distress and/or dysfunction because of ADD/ADHD.

It should be kept in mind that many ADD/ADHD individuals are successful, happy, and productive. In fact, their ADD/ADHD characteristics contribute significantly to their ability to be creative and to their emotional strength especially if the environment in which they live and work is accepting of how they function.

The importance and influence of the environment on ADD/ADHD people cannot be over stressed. For example, most ADD/ADHD children are first diagnosed because they are in conflict with their school and home environment. They are not able to sit still when required to do so by the teacher. They act-out at home because of their unfocused energy and their difficulty falling asleep at night when put to bed.

The importance of the home, school and work environment also applies to teenagers and adults. On the other hand, ADD/ADHD adults who are, say, computer programmers often are allowed to go to work around noon (late) and stay at work until midnight (late). This is an example of a work environment being compatible with how the ADD/ADHD brain typically functions. When workers are highly valued by the business and in an accepting work environment, keeping strange hours need not be a significant personal problem nor necessarily a cause of distress. Unfortunately, many ADD/ADHD teenagers find traditional schooling a hostile, boring, unaccepting environment which cannot be changed as adults can change work environments.

The search for ADD/ADHD behavioral characteristics is the starting place. Confirmation of dysfunction due to ADD/ADHD behaviors is, however, necessary for treatment to be justified. My approach to ADD/ADHD continues to be, "If it ain't broke, don't fix it!" By the way, if treatment is indicated and proper, it is good to know that creativity and productivity is expected to be enhanced, not reduced.